Author Topic: Retrolabyrinth approach ?  (Read 6924 times)

ncbj

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Retrolabyrinth approach ?
« on: May 14, 2012, 05:54:14 am »
Hi,

Anybody having experience with the Retrolabyrinth approach ? I have been told that they use the same way in as for the Translab, however it should be possible to preserve the hearing (app 50%). When surfing in this forum I haven't read much about this technique. I have been "offered" this kind of surgery to take place in 2 weeks time but. A little bit of experience from somebody else would be just fine :o)

Regards,
Niels

Tod

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Re: Retrolabyrinth approach ?
« Reply #1 on: May 14, 2012, 03:29:59 pm »
The approach they used on me was a combination of retrosigmoid and translab, but it was not called this, nor was it offered as a way to save hearing. My hearing was effectively gone. In my case it simply necessary to get at the tumor and protect all the involved nerves.

-Tod
Bob the tumor: 4.4cm x 3.9cm x 4.1 cm.
Trans-Lab and Retro-sigmoid at MCV on 2/12/2010.

Removed 90-95% in a 32 hour surgery. Two weeks in ICU.  SSD Left.

http://randomdatablog.com

BAHA implant 1/25/11.

28 Sessions of FSR @ MCV ended 2/9/12.

leapyrtwins

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Re: Retrolabyrinth approach ?
« Reply #2 on: May 14, 2012, 07:03:26 pm »
Never heard of this approach.

I'm aware of mid-fossa, retrosigmoid (aka sub-occipital) and translabyrinth (translab).

Jan
Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

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nftwoed

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Re: Retrolabyrinth approach ?
« Reply #3 on: May 15, 2012, 09:41:46 am »
Hi Niels;

  I've heard of it, but don't recall where or how it was done.
  Am anxious to read your outcome! This may have been the approach used on the John Hopkins pt. who had a late placement cochlear implant by Niparko. The auditory nerve was preserved at the semi-circular canals, it's length, and at the brain stem's auditory cortex.
  Of course a regular translab nearly guts the inner ear and severs the 8th crainial nerve ( what's left of it ) at the brain stem.
  Best wishes!

geexploitation

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Re: Retrolabyrinth approach ?
« Reply #4 on: May 19, 2012, 09:22:29 am »
Hi Niels,

I just came across a mention of "retrolabyrinthine" in a paper the other day and was curious about it. I hadn't heard of it; it's certainly not a commonly tossed around term.

Personally, I would love to learn a bit more about it. Do you know what characteristics of your tumor necessitate this approach? Do you know of any good papers or online sources that you could point we toward that might explain this surgical route?

Feel free to PM me. Thanks!

Sean
=========================
41 mm x 24 mm x 28 mm probable AN diagnosed 1/10/2012.
Surgically diagnosed 7/9/2012 as TRIGEMINAL schwannoma and removed via retrosigmoid at MGH in Boston, MA by Drs. Barker and McKenna.

ncbj

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Re: Retrolabyrinth approach ?
« Reply #5 on: May 19, 2012, 10:29:16 am »
Hi,

I have decided not to take the surgery in 2 weeks time. So now I have taken a timeout.

I am a little bit reluctant about the retrolab. I have surfed the internet and I can only find a couple of articles linking AN and retrolab - but they dates 10-15 years back in time. If it is a good method, why isn't it more widespread by now ? Apparently the danish doctors are not allowed to do the middle fossa due to some not so successful surgeries a couple of years ago.

In the mean time I have had a web-consultation with Dr. Friedman from House. He suggests the middle fossa. For the time being I am considering the option of going to LA. From my time spent in this forum I think this would be a very good solution :o)
 
However, I have to find out whether it is financially viable. I only have limited insurance as we normally have a very good functioning public health care in Denmark.

Niels

geexploitation

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Re: Retrolabyrinth approach ?
« Reply #6 on: May 19, 2012, 10:40:59 am »
Good for you -- it takes guts to take a timeout.

Are you currently in Denmark? Might this place in Hannover, Germany be a viable treatment center for you? They've got a sterling reputation for brain tumors.

http://www.ini-hannover.de/en/home.html
=========================
41 mm x 24 mm x 28 mm probable AN diagnosed 1/10/2012.
Surgically diagnosed 7/9/2012 as TRIGEMINAL schwannoma and removed via retrosigmoid at MGH in Boston, MA by Drs. Barker and McKenna.

nftwoed

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Re: Retrolabyrinth approach ?
« Reply #7 on: May 19, 2012, 01:43:52 pm »
Hi;

  I understand Dr. Samii and clinic are both very excellent!

  If memory serves correctly, there is also an excellent facility in Belgium.

pjb

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Re: Retrolabyrinth approach ?
« Reply #8 on: May 19, 2012, 05:13:37 pm »
Hi,

I have decided not to take the surgery in 2 weeks time. So now I have taken a timeout.

I am a little bit reluctant about the retrolab. I have surfed the internet and I can only find a couple of articles linking AN and retrolab - but they dates 10-15 years back in time. If it is a good method, why isn't it more widespread by now ? Apparently the danish doctors are not allowed to do the middle fossa due to some not so successful surgeries a couple of years ago.

In the mean time I have had a web-consultation with Dr. Friedman from House. He suggests the middle fossa. For the time being I am considering the option of going to LA. From my time spent in this forum I think this would be a very good solution :o)
 
However, I have to find out whether it is financially viable. I only have limited insurance as we normally have a very good functioning public health care in Denmark.

Niels

Just wanted to say from what I have heard and also that I have spoken to Dr. Friedman that would be a great decision if you can have it done there....Good luck

Best Wishes,
Diagnosed with a 1 cm. AN had Retrosigmoid
Approach surgery July of 2009, several problems after surgery.

ncbj

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Re: Retrolabyrinth approach ?
« Reply #9 on: May 23, 2012, 11:32:47 am »
I have finally taken my decision: Middle Fossa at House at 8/8/12. Drs Friedman & Schwarz.

Based on a lot of treads in this forum I find this a safer choice compared to the unknown "retrolab" in Copenhagen.

I have to travel a long distance - and have to pay partly by myself. But this is a once-in-a-lifetime  ... I certainly hope ... so I don't want to regret anything afterwards.

Niels

Jim Scott

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Re: Retrolabyrinth approach ?
« Reply #10 on: May 23, 2012, 02:36:38 pm »
Niels ~

Congratulations on your decision.  I'll add that I believe it is a very sound decision and of course, I wish you complete success which, with the doctors at HEI, is entirely possible. 

Jim
4.5 cm AN diagnosed 5/06.  Retrosigmoid surgery 6/06.  Follow-up FSR completed 10/06.  Tumor shrinkage & necrosis noted on last MRI.  Life is good. 

Life is not the way it's supposed to be. It's the way it is.  The way we cope with it is what makes the difference.

lrobie

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Re: Retrolabyrinth approach ?
« Reply #11 on: May 24, 2012, 10:18:11 am »
Neils,

I'm glad that you've made the decision to go to House.  I will be there ahead of you with Drs. Friedman and Schwartz.  Mine is scheduled for July 18th.  Keep an eye out for my post-op posts.  I'm having middle-fossa too.

Lisa
6/2009 7mm x 4mm  W&W
8/2011 9.5mm x 5mm
2/2012 UPMC Follow-up , slight growth
Surgery on 7/18/12 w/Drs. Friedman & Schwartz (mid-fossa)
www.caringbridge.org/visit/lisarobie

mindyandy

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Re: Retrolabyrinth approach ?
« Reply #12 on: May 24, 2012, 10:21:30 am »
NCBJ
I'm glad to hear you made your decision. Its a tough one. Dr. Friedman & Schwartz is a wonderful choice.
14mm dx 9/07. CK done Seattle  1 year MRI showed some shrinkage. 4 year MRI 2mm growth nothing conclusive. Trigminal nerve involvment Retrosigmoid Friedmand/Schwartz HEI March 7,2012

ncbj

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Re: Retrolabyrinth approach ?
« Reply #13 on: May 25, 2012, 01:39:23 pm »
Lisa, I will certainly look for your posts. Now it all just seems surreal to me ...

LizAN

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Re: Retrolabyrinth approach ?
« Reply #14 on: May 25, 2012, 08:50:36 pm »
Neils,

I will be there on July 3rd, with Slattery and Schwartz.  Many have gone before us.

Liz
8/20/2010 - 9mm AN on left side 
Fullness, tinnitus, mild hearing loss
2/20/2011 - 8mm
4/20/2012 - 12.4 mm
Moderate to severe hearing loss, LOUD tinnitus, deteriorating balance
Facial numbness and twitching, which subsided pre-surgery
Translab at House, 7/3/2012, Slattery and Schwartz